Question: Hello !

I know that reading too much maks you confused !

Question about disseminated strongyloidiasis -

it is rare - in China there is lot of strongyloidiasis infections but - strongyloidiasis Superifection rare

Since the first case of strongyloidiasis reported in China in 1973, there have been 330 confirmed cases as of 2011

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/

And also in Japan it is rare

January 1975–December 2017. The 70 patients were classified into 3 clinical phenotypes: dissemination (32 patients [45.7%]), occult dissemination with meningitis caused by enteric

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/

There are some speculating statement

Although once thought rare, disseminated strongyloidiasis may be relatively common in high risk populations and frequently misdiagnosed as isolated gram negative sepsis or acute respiratory distress syndrome.17,18

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/

This is speculating - with no prove because there has been only studies with few case

Nine patients, all of Southeast Asian heritage, were identified. Eight patients immigrated to the United States > or = 3 years prior to acute presentation. All patients were receiving antecedent corticosteroids; in five patients, therapy was for presumed asthma. Absolute eosinophil counts > 500/microL occurred in only two patients prior to steroid initiation. Eight patients presented with respiratory distress, and Gram-negative sepsis developed in four patients. Four patients had evidence of right-heart strain on ECG or echocardiography at the time of presentation. Three patients died; all had eosinophil counts of < 400/microL.

https://read.qxmd.com/read/0000/strongyloides-hyperinfection-presenting-as-acute-respiratory-failure-and-gram-negative-sepsis

The following case is typical of a Strongyloides infection presenting to an infectious diseases service at a tertiary care hospital: A 50-year-old man who was originally from Cambodia but who had lived in Canada for the past 15 years presented with nausea and vomiting. His history was notable for

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC514646/






So in conclusion - patients do take impresioniste therapy - it could lead to strongolitis hyperinfection - but it is relative rare !

Thank you

So in Conclusion !
So to be 100 % that i dont get disseminated strongyloidiasis- i should do such scenario

1.As in i m biologist and travel around the world and im in risk for strongyloidiasis - if i go to hospital and treat some conditions with corticosteroid for examle for covid - i should say to doctor that is should be treated with ivermectin at the same time with corticosteroid as i understand i will reduce my risk for disseminated strongyloidiasis close to 0%

2. Corticosteroides for athletes injury ar lower dose than in hospital patients - and is not a risk factor for disseminated strongyloidiasis as Corticosteroides level are much lower

Than you !

Thank you for your answer -

1.strongyloides treatment is at least 2 weeks - in when you need hospitalization for Covid or other serious disease there is no time to wait - so ivermectin could be treated together with corticosteroides to avoide strongyloides hyperinfection ! It should be logic !

2. In literature it is said when you are on immune suppression drugs you should treat each 3 month - to avoid strongyloides hyperinfection, because you could be reinfected in nature

Than you very much !